The long-term goal of this proposal is to develop commercial software and related services which will provide for new types of electronic interactions between healthcare providers and elderly individuals who need outpatient or home healthcare services for chronic medical conditions. It will substitute information technology for both physician and nursing services to such patients, thereby reducing expenditures for care and providing better health outcomes. The specific aims of Phase I are (l) to design the software components of an interactive multimedia system for the home management of older adults with chronic medical conditions; (2) to prototype and demonstrate several components of such a system; and (3) to develop a study design for evaluating its clinical efficacy and cost- effectiveness. The key output will be a full functional specification for an interactive multimedia home healthcare information system that deals with clinical problems representing a majority of visits to urban medical clinics.